MEDICARE: LICOLN HOSPITAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282N00000X	General Acute Care Hospital

General Provider Information

NPI Number	:	1245519685
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LICOLN HOSPITAL

Provider Business Mailing Address
First Line	:	234 E 149TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10451-5504
Country	:	US
Telephone Number	:	718-579-5016
Fax Number	:

Provider Business Practice Location Address
First Line	:	234 E 149TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10451-5504
Country	:	US
Telephone Number	:	718-579-5016
Fax Number	:

Authorized Official
Title or Position	:	PGY1
Name	:	DR. MOHAMMAD ALKAYEM
Credential	:	M.D
Telephone Number	:	718-579-5016

Provider Enumeration Date	:	08/16/2011
Last Update Date	:	08/16/2011

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Directions to “LICOLN HOSPITAL ” Practice Location

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